Provider Demographics
NPI:1184396020
Name:LEYVA, MAIKEL (BCBA)
Entity type:Individual
Prefix:MR
First Name:MAIKEL
Middle Name:
Last Name:LEYVA
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6570 LAKE BLUE DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-3004
Mailing Address - Country:US
Mailing Address - Phone:305-469-0117
Mailing Address - Fax:
Practice Address - Street 1:6570 LAKE BLUE DR
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-3004
Practice Address - Country:US
Practice Address - Phone:305-469-0117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-29
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-53475103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst